Amphetamine Ingestion Research Articles

Hypoglycemia and presumptive rhabdomyolysis secondary to lisdexamfetamine toxicosis in 3 cats.

To describe the clinical course and novel biochemical changes in 3 cats with lisdexamfetamine (LDX) toxicosis. Three cats presented with LDX exposure and initially displayed typical clinical signs of amphetamine toxicosis. However, over the course of hospitalization, hypoglycemia and markedly elevated creatine kinase levels consistent with rhabdomyolysis ensued. All cats were treated with sedatives including phenothiazines and dexmedetomidine. Two cats were hospitalized for 4 days and 1 for 5 days. All cats survived. This is the first case series in cats that reports the novel biochemical changes of delayed hypoglycemia and elevated creatine kinase several days into hospitalization for the treatment of LDX toxicity. The development of delayed clinical signs suggests reconsideration of established hospitalization guidelines for amphetamine ingestion in cats.

Urinary retention concomitant with methamphetamine use: a case report

BackgroundUrinary retention is a condition in which impaired emptying of the bladder results in postvoid residual urine. It can be acute or chronic urinary retention. There have been only scattered case studies that have described urinary retention resulting from methamphetamine use. This case report is aimed at raising awareness about methamphetamine abuse as an important factor in the aetiological considerations when evaluating cases of urinary retention among healthy younger age groups.Case presentationWe report a patient who had acute urinary retention after brief amphetamine use. A 26-year-old Nigerian man presented at the emergency room on account of an inability to pass urine and lower abdominal pain. Before this incident, the patient reported a recent ingestion of amphetamine to achieve weight reduction and a fit body. A week after use, he started to experience difficulty passing out urine hence necessitating a visit to the emergency department. After a brief assessment, physical examination revealed a man in painful distress with mild suprapubic fullness. He had a successful passage of a urethral catheter for continuous bladder drainage with dramatic improvement in his symptoms. He was subsequently discontinued on methamphetamine use and referred to a urologist for further evaluation.ConclusionMost cases of urinary retention are diagnosed clinically and are rarely missed. But because urinary retention is associated with a wide range of aetiological factors, clinicians need to be aware of the effects of certain drugs in the aetiology of urinary retention. In the management of a case of urinary retention in the younger age group, clinicians should enquire about a history of drug use, the drug of particular interest being methamphetamine, and also employ the use of urodynamic studies in the evaluation of such cases.

S2630 NAC Saved the Liver One More Time, Use of N-acetylcysteine in Amphetamine-Induced Acute Liver Failure

INTRODUCTION: Amphetamine is a popular recreational drug in the western world, it induces euphoria and boost self-confidence. Excessive dose causes agitation, hallucination, cardiovascular manifestation, and hyperthermia. Hepatotoxicity have been reported in the literature with no clear treatment recommendation. On the other hand, N-acetylcysteine (NAC) is a known medication used to treat acetaminophen induced hepatitis. NAC works as hepatoprotective agent via multiple mechanisms, including restoring hepatic glutathione, and serving as a glutathione substitute. We are presenting a case of ALF after sudden ingestion of amphetamine with rapid recovery after administration of intravenous NAC. CASE DESCRIPTION/METHODS: A 20-year-old male with no significant past medical history presented with palpitation after ingesting 2 grams of methamphetamine. he soon became obtunded and was intubated to protect his airway. He was also hypertensive, hyper thermic ∼108F and tachycardic. The rest of his physical exam was normal. Patient urine toxicology was positive for Amphetamine and stat to develop multi-organ failure including severe acute liver failure in less than 24h from admission. Patient PT/PTT/INR peaked around day 3, same wise, s. total bilirubin, AST, and ALT with the later peaked around 2,500 IU/L respectively. on the other hand, s. total protein and s. albumin reached a nadir around the same time period. N-acetylcysteine IV loading followed by maintenance does was started around 6 h after admission, with a significant recovery in liver enzymes started after only 3 days of therapy and normalization of AST, ALT and PT/INR/PTT observed by day 5. DISCUSSION: NAC, which is an established antidote in acetaminophen induce ALF, works via multiple mechanism mainly include supplying cysteine for glutathione synthesis and thus reduce oxidative stress. It was used successfully in treating our patient amphetamine induce acute hepatitis. Hence, we believe that more studies need to be conducted to investigate the extended role of NAC in treating cases of acute hepatitis.Figure 1.: Graph 1—AST, ALT peaked in the first few days then recovered with the use of NAC.Figure 2.: Graph 2—PT/PTT/ INR elevation and recovery over time with the use of NAC.Figure 3.: Graph 3—bilirubin continued to raise and peaked after AST/ALT then start to trend down while the total protein and Albumin showed the opposite curve.

Lessons learned by giving amphetamine to antipsychotic-medicated schizophrenia patients.

Experimental Medicine studies in psychiatric populations test specific, mechanistic hypotheses related to the biology of mental illness, by combining well-characterized neurobiological probes and laboratory-based measures of behavioral performance and neurobiology. However, scientific inquiry through the acute administration of psychoactive drugs to patients with serious mental illness raises important ethical issues. These issues arise in studies in which the psychostimulant, amphetamine, is used as an Experimental Medicine probe in patients with schizophrenia. In this study, we summarize relevant aspects of our experience with acute, laboratory-based challenges of amphetamine in schizophrenia patients. Schizophrenia patients participated in one or more Experimental Medicine studies involving limited doses of amphetamine with clinical monitoring, over a 4-year period. Acute (within hours of ingestion; collective n = 53), subacute (three active doses over 4 weeks; n = 28), and long-term (mean = 17 months after ingestion; n = 19) effects of amphetamine ingestion were assessed. In antipsychotic (AP)-medicated schizophrenia patients, amphetamine was associated with no detrimental subjective, autonomic, or functional changes. Symptoms assessed acutely, subacutely, or long term were either unchanged or diminished. No adverse acute, subacute, or long-term consequences from the Experimental Medicine use of amphetamine in antipsychotic-medicated schizophrenia patients were detected. These findings do not address the safety or effectiveness of the use of amphetamine in unmedicated patients, or as an adjunctive treatment for schizophrenia. Indeed, it is important to distinguish evidence-based risks of symptom exacerbation in an Experimental Medicine setting vs. risks associated with long-term, daily clinical use or even misuse of amphetamine.

A case series involving young children presenting with accidental ingestion of amphetamine based stimulants

•Attention Deficity Hyperactivity Disorder (ADHD) affects adults and children.•Stimulant prescribing for ADHD is increasing.•Overdose of amphetamine based stimulants results in a sympathomimetic toxidrome.•Lisdexamfetamine dimesylate is the first prodrug stimulant developed to treat ADHD.

Memory impairment induced by amphetamine derivatives in laboratory animals and in humans: a review.

Abstract The 20th century brought with it the so-called club drugs (the most notorious being amphetamine derivatives), which are used by young adults at all-night dance parties. Methamphet-amine and 3,4-methylenedioxymethamphetamine (MDMA or ecstasy) are synthetic drugs with stimulant and psychoactive properties that belong to the amphetamine family. Here, we have reviewed the literature about the cognitive impairment induced by these two amphetamine derivatives and the preclinical and clinical outcomes. Although there is controversial evidence about the effect of methamphetamine and MDMA on learning and memory in laboratory animals, results from published papers demonstrate that amphetamines cause long-term impairment of cognitive functions. A large number of pharmacological receptors have been studied and screened as targets of amphetamine-induced cognitive dysfunction, and extensive research efforts have been invested to provide evidence about the molecular mechanisms behind these cognitive deficits. In humans, there is a considerable body of evidence indicating that methamphetamine and MDMA seriously disrupt memory and learning processes. Although an association between the impairments of memory performance and a history of recreational amphetamine ingestion has also been corroborated, a number of methodological difficulties continue to hamper research in this field, the most important being the concomitant use of other illicit drugs.

Auditory gamma activity after stimulant administration in patients with ADHD

Event Abstract Back to Event Auditory gamma activity after stimulant administration in patients with ADHD Tony W. Wilson1*, Matthew L. White2, Nichole L. Knott1 and Martin W. Wetzel3 1 University of Nebraska Medical Center, Department of Neurological Sciences, United States 2 University of Nebraska Medical Center, Department of Radiology, United States 3 University of Nebraska Medical Center, Department of Psychiatry, United States Attention-deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder affecting approximately 8% of children and persisting in 4% of adults. Symptoms include inattention, impulsivity, and hyperactivity. Regardless of age stimulant medications are the most effective treatment for ADHD, although their mechanism of action is poorly understood. In the current study, we examined auditory gamma-frequency responses before and ~75 minutes after oral amphetamine administration. Gamma activity has been implicated in the temporal binding of stimulus properties across distinct cortical areas, as well as other forms of complex information processing. Adult outpatients with ADHD listened to ~150 trials of binaurally presented click trains (inter-click-interval=25 ms; duration=500 ms; ISI=1.2 s) per session as whole-cortex magnetoencephalography (MEG) data were acquired. These data were transformed into a standard device-centered head position, corrected for head movements that occurred during the recording, coregistered to the participant’s MRI, inspected for artifacts, time-domain averaged, and bandpass filtered around the 40 Hz steady-state response. Bilateral neural generators of the peak 40 Hz response were localized and this two-source model was used to calculate an inverse spatial filter for deriving source waveforms. Our results indicated that amphetamine ingestion is associated with significantly increased gamma-band activity in the auditory cortices. These results may indicate that adults with ADHD have reduced high-frequency activity at baseline (suggesting impaired cortical inhibitory function), and that amphetamine medications act to normalize such gamma activity (and thereby GABA function) across the cortex. Work in our laboratory is currently investigating this and other competing hypotheses to characterize the implications of reduced gamma activity in patients with ADHD and the corresponding clinical benefits of stimulant therapy. Conference: Biomag 2010 - 17th International Conference on Biomagnetism , Dubrovnik, Croatia, 28 Mar - 1 Apr, 2010. Presentation Type: Poster Presentation Topic: MEG: Clinical applications Citation: Wilson TW, White ML, Knott NL and Wetzel MW (2010). Auditory gamma activity after stimulant administration in patients with ADHD. Front. Neurosci. Conference Abstract: Biomag 2010 - 17th International Conference on Biomagnetism . doi: 10.3389/conf.fnins.2010.06.00296 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 05 Apr 2010; Published Online: 05 Apr 2010. * Correspondence: Tony W Wilson, University of Nebraska Medical Center, Department of Neurological Sciences, Omaha, United States, tony.w.wilson@gmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Tony W Wilson Matthew L White Nichole L Knott Martin W Wetzel Google Tony W Wilson Matthew L White Nichole L Knott Martin W Wetzel Google Scholar Tony W Wilson Matthew L White Nichole L Knott Martin W Wetzel PubMed Tony W Wilson Matthew L White Nichole L Knott Martin W Wetzel Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

The development and initial validation of a questionnaire to measure craving for amphetamine.

To develop and initially validate a multi-dimensional questionnaire to measure cravings for amphetamine (speed). The design of the Desires for Speed Questionnaire (DSQ) was based on the Desires for Alcohol Questionnaire and was administered to 174 amphetamine users. Exploratory factor analyses were carried out on the data and relationships between questionnaire score and other variables were assessed. Further analyses were carried out to assess the sensitivity of the factor scores of the DSQ to various methods of amphetamine ingestion. Factor analysis revealed that a four-factor solution best described the data and that each of these factors were differentially sensitive to methods of amphetamine ingestion, with greater craving on all measures in intravenous amphetamine users. The factor structure identified from the present analysis was almost identical to that identified in recreational drinkers by Love et al. (1998). The results validate and extend the findings of the work of Love et al. (1998) and provide support for a multifactorial account of amphetamine craving.

Drug Testing in Blood: Validated Negative-Ion Chemical Ionization Gas Chromatographic–Mass Spectrometric Assay for Determination of Amphetamine and Methamphetamine Enantiomers and Its Application to Toxicology Cases

Enantioselective analysis of amphetamine (AM) or methamphetamine (MA) in urine is already a well-established tool for differentiation of illicit from therapeutic ingestion of AM or MA derivatives. However, because of the increasing importance of plasma or serum in analytical toxicology, a method for enantioselective analysis of AM and MA in these matrices is needed. AM and/or MA were extracted from 0.2 mL of blood plasma or serum by mixed-mode solid-phase extraction. After derivatization with S-(-)-heptafluorobutyrylprolyl chloride, the resulting diastereomers were separated by gas chromatography on a HP-5MS column during a 15-min program and detected by mass spectrometry in the negative-ion chemical ionization mode (NICI-GC-MS). The method was fully validated and applied to >50 samples from authentic toxicology cases. The derivatized AM and MA enantiomers were well separated and sensitively detected. The method was linear from 5 to 250 micro g/L per enantiomer with analytical recoveries, accuracy, and within- and between-run precision well within required limits. Extraction yields were 88.9-98.6%. Implications of concentrations and enantiomeric composition of AM and MA in the authentic samples were considered. This sensitive, reliable, rapid NICI-GC-MS assay is suitable for enantioselective determination of AM and MA in blood plasma or serum samples.

Efficacy of two commercial products for altering urine drug test results.

We have become aware of several commercial products that, when orally ingested, will purportedly not only eliminate "toxins" from a person's system, but will also correct any urinary imbalances caused by excessive water consumption. Unblinded study of one volunteer subject, tested weekly x 4 for 24-hour urine elimination of test drug under conditions of control, control plus 1200 mL water, Quick Flush', and Eliminator. Each of the treatment protocols studied caused reductions of drug or metabolite concentrations as measured by gas chromatography-mass spectrometry in urine specimens collected up to 24 hours after ingestion of amphetamine, 9-carboxy-11-nor-delta-9-THC, benzoylecgonine, or codeine, yet the radioimmunoassay screening results demonstrated very little effect. Water alone was approximately as effective as the two commercial products in reducing the metabolite level. None of the treatment protocols employed in this study altered urinary pH, specific gravity, or creatinine concentration outside the normally accepted physiological range. Attempts to conceal drug abuse by water dilution are most likely to play a substantial role when concentrations are at or near the detection threshold for a particular assay such as the terminal stages of drug eliminations.

Severe myocardial injury and rhabdomyolysis from acute oral amphetamine abuse

ABSTRACTWe report a case of a previously healthy young man who developed severe myocardial injury and rhabdomyolysis after a single oral ingestion of amphetamine. Such major toxicity is more usually associated with the use of intravenous amphetamine or chronic amphetamine abuse. Both physicians and potential drug users need to be aware that a single oral ingestion of amphetamine may produce severe, life‐threatening toxicity.

Amphetamine Ingestion Presenting as Eclampsia

Departments of Anaesthesia and Obstetrics and Gynaecology, University Hospital, Nottingham, England

Amphetamine ingestion presenting as eclampsia

A case of amphetamine abuse in late pregnancy is reported. The presenting features of convulsions, confusion, agitation with hypertension and proteinuria led to a diagnosis of eclampsia for which a caesarean section was performed. Investigations and differential diagnosis of convulsions in late pregnancy are reviewed. A general urinary drug screen gives results after 24 hr whereas, if amphetamine abuse is suspected, this can be confirmed within three hr if a specific test for urinary amphetamines is performed. The sympathomimetic effects of a single dose of amphetamine are contrasted with the depression of the sympathetic nervous system which occurs after long-term use. Implications for anaesthesia are discussed.

Effects of food deprivation on subjective responses to d-amphetamine in humans

The effects of 24 hours of food deprivation on the subjective response to 10 mg oral d-amphetamine were studied in 12 healthy normal volunteers. A within-subjects design was used in which subjects ingested amphetamine and placebo capsules in both a fed and a fasting state. Each of the four experimental conditions—FED/DRUG, FED/PLACEBO, FAST/DRUG, FAST/PLACEBO—was enacted twice according to a randomized block design. Three subjective effects questionnaires, the Profile of Mood States, the Addiction Research Center Inventory, and the Visual Analogue Scale, were completed prior to and 1, 3 and 6 hr after the early morning capsule ingestion. Typical elevations in such subjective effects as elation and vigor were obtained after amphetamine ingestion in both feeding conditions, but fasting neither potentiated nor attenuated the drug response. Subjects at the end of the session, however, were more likely in the FAST/DRUG condition than in the FED/DRUG condition to label the capsule they had ingested at the beginning of the session as a stimulant.

Khat consumption: a pharmacological review

The present review deals with the considerable body of evidence gathered in the last ten years on the clinical and experimental pharmacology of Khat. Khat effects are generally agreed to be of amphetamine-like type. In particular, Khat ingestion, like amphetamine ingestion, produces sympathetic activation, anorexia, euphoria, increased intellectual efficiency and alertness. These effects are mainly mediated by phenylalkylamines, such as cathinone and cathine, because the pharmacological actions of these agents and those produced by amphetamine almost overlap. In infra-human species cathinone is an effective positive reinforcer (i.e., it maintains self-administration). However, it would be inappropriate to infer from cathinone and cathine effects assessed in animals a high potential of abuse for Khat in humans; apart from other reasons the bulk volume of Khat leaves, limits the ingestion of high quantities of the active principles. Accordingly, in habitual consumers Khat dependence is probably mild, because craving and tolerance to the sympathomimetic and neuroendocrine effects of Khat are present, but there is no definite abstinence syndrome. Therefore, in our opinion, policies restricting the use of Khat should be adopted with caution, lest they simply change the pattern of drug abuse and increase the spread of more dangerous drugs.

Neuroendocrine and electroencephalographic sleep changes due to acute amphetamine ingestion in human beings.

Amphetamine, a clinically used sympathomimetic central-acting drug, was administered in Spansule capsules in a blind schedule to 8 normal obse volunteers in a daily (8 a.m.) single 15 dose for 7 days. The study, conducted in the metabolic ward, included two 7 day placebo periods (pre- and post-drug). During the 1st placebo period, all subjects exhibited within the 1st 2 h of sleep a clear and significant nocturnal increase of growth hormone (GH) closely related with sleep stages 3 and 4. Thyrotropin (TSH) increase was observed between 01.00 to 04.00 h and was accompanied by a reduction of thyroxine (T4) levels. Cortisol levels presented their characteristic rhythm, clearly associated with paradoxical sleep (REM). Amphetamine significantly reduced stages 3 and 4, as well as REM sleep, and increased stage 2. GH and cortisol circadian profiles were preserved, although their magnitude was diminished. The extent of nocturnal TSH and T4 changes was significantly reduced. Drug withdrawal was accompanied by a rebound of REM sleep and a trend to recover the pretreatment TSH and T4 temporal profile. These results suggest that adrenergic neurotrasmitters may be a significant modulating system for TSH and cortisol, whereas GH nocturnal secretion may be influenced by different mechanisms.

Effect of methamphetamine on water consumption.

Comparison of water consumption by albino rats showed that decreases induced by ingestion of amphetamine were limited to the effective action of the drug and compensated for subsequently.

Amphetamine ingestion with biliary atresia

CONGENITAL biliary obstruction is estimated to occur once in 20 to 30 thousand births? Biliary atresia is generally attributed to faulty embryogenesis, but it has been suggested that it may be an acquired lesion related to neonatal hepatitis. 2 Medications ingested at critical times during embryonic development can cause malformations. Biliary atresia associated with drug ingestion has not been previously reported. An observation of prenatal ingestion of amphetamines in mothers of infants with biliary atresia is recorded here.

Toxic effect of stramonium simulating LSD trip

Four cases of stramonium poisoning in teen-agers secondary to ingestion of Asthmador asthmatic powder (stramonium-belladonna mixture) presented as LSD reactions. The clinical manifestations were acute brain syndrome and physical signs of atropinization. The effects of stramonium ingestion are similar to the effects of the ingestion of amphetamine and LSD, but in addition to the psychosis due to toxic reaction, the patient who has ingested stramonium typically has dry mucous membranes and is hot and flushed.

Toxic Effect of Stramonium Simulating LSD Trip

Four cases of stramonium poisoning in teen-agers secondary to ingestion of Asthmador asthmatic powder (stramonium-belladonna mixture) presented as LSD reactions. The clinical manifestations were acute brain syndrome and physical signs of atropinization. The effects of stramonium ingestion are similar to the effects of the ingestion of amphetamine and LSD, but in addition to the psychosis due to toxic reaction, the patient who has ingested stramonium typically has dry mucous membranes and is hot and flushed.